{"id":407,"date":"2024-11-09T10:37:20","date_gmt":"2024-11-09T10:37:20","guid":{"rendered":"https:\/\/uninsuredunaware.org\/?page_id=407"},"modified":"2026-10-11T21:40:16","modified_gmt":"2026-10-11T21:40:16","slug":"the-enrollment","status":"publish","type":"page","link":"https:\/\/uninsuredunaware.org\/es\/learn\/the-enrollment\/","title":{"rendered":"La inscripci\u00f3n"},"content":{"rendered":"\n
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The enrollment<\/strong><\/h1>\n<\/div><\/div>\n\n\n\n
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How do I enroll? Where do I enroll? What do I need to enroll? <\/em><\/p>\n<\/blockquote>\n\n\n\n

Have all your questions about the enrollment period answered here!<\/p>\n\n\n\n

Click to expand the drop menus:<\/em><\/p>\n\n\n\n

What is it?<\/summary>\n
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Open enrollment is the time period allotted for families and individuals to sign up for a health insurance plan for the following year through a public health insurance marketplace or through employer-offered coverage.\u00a0

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Marketplace<\/em>:
The online marketplaces were established within the Affordable Care Act (ACA) in order to allow more affordable rates based on income. This means if you are eligible to shop in the Marketplace, the prices you are offered (for copayments, deductibles, and premiums<\/a>) will typically be lower than the original cost of that plan through the private carrier themselves. Each state has their own Marketplace. The Marketplace also allows you to purchase a dental plan alongside your health insurance, although both will be separate entities.

If you are an immigrant without citizenship status or a greencard, you may still be eligible for health insurance through the Marketplace given you have documentation to show you have some form of active status or recent communication from the USCIS.

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Employment:<\/em><\/p>\n\n\n\n

There is also an open enrollment period for employment-based coverage. The company decides what carrier and plans to offer to their employees, giving you a more limited choice. The options will usually include a plan that offers their lowest premium offering and other plans that may be more expensive with varying deductible\/premium options.

You are also typically offered FSA and HSA plans which allow you to have more control on how much you invest into your insurance coverage. These types of plans are not offered through Marketplace.

If you are offered “affordable” health insurance through your employer, meaning you can technically afford the cost of insurance with your paycheck, the Marketplace may not be a great option since you may not be offered many tax credits to offer you lower premium plans. You should still check to compare with your employment to confirm what your best option is.<\/p>\n<\/div>\n\n\n\n

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Do I need to?<\/summary>\n
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You are not required to purchase your health insurance from the Marketplace or employer and can go directly through a carrier. However, when going through a carrier directly, you will not receive those discounted prices (called premium tax credits and cost-sharing reductions – based on your income) that many individuals are eligible for.

If you don\u2019t get health insurance at all (through any outlet of Marketplace, carrier, or employer), four states enforce a penalty: New Jersey, California, Rhode Island, Massachusetts, and Washington D.C.\u00a0

If you\u2019re in a state without a penalty, be aware that choosing to not have health insurance at all will put you in a position of having barely any accessibility to healthcare services. One accident or illness can put you in the face of a medical debt and inability to access prescriptions for treatments without spending hundreds of dollars on urgent care and testing.\u00a0

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Note:
<\/em>Money is difficult, especially when you need groceries, rent, car payments, etc. But before kicking out the idea of health insurance completely, go through the Marketplace application to see if you\u2019re eligible for discounts because it\u2019s possible you can be offered a plan with a very low premium. It would also let you know if you\u2019re eligible for Medicaid instead, which can offer $0 premiums and copays.

While employer-based plans may still be expensive, remember that the cost of the premium would be deducted from your gross pay before taxes rather than your final paycheck, and thus may also lower the amount of overall taxes cut from paycheck.

After knowing what you\u2019re offered, make your decision from there on what\u2019s best for you.<\/p>\n<\/div>\n\n\n\n

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When is it?<\/summary>\n
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The time period every year for the Marketplace is from November 1 to January 15 of the next year<\/strong>.\u00a0This may differ slightly by days for employment-based coverage, though the general period is the same (exact dates should be communicated to you by HR).<\/p>\n\n\n\n


Medicare has a different annual time period from October 15 to December 7.

Special tip for Marketplace coverage: If you\u2019d like your coverage to begin on January 1st for the new year, enroll before December 15th. Keep in mind, you will need to submit required documents and wait for them to be verified, so do not wait till the 15th to submit your application.

If you complete your enrollment after December 15, your coverage will begin February 1 of the next year. This means any appointments or services you have in January will not be covered<\/strong>. This does not apply for employment-based coverage.
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What if I miss the enrollment period?<\/summary>\n
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If you miss the enrollment period, you may not need to wait till next year.\u00a0

Most marketplaces and employers offer a Special Enrollment Period. This period is for any time of the year that\u2019s not the enrollment period, and allows individuals to apply for multiple circumstances. According to healthcare.gov, these reasons can include: \u201clife events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.\u201d

The criteria to be eligible for Special Enrollment will differ for employment-based coverage and may be more rigid, such as income changes not being a valid reason to qualify.

If you miss the enrollment period and can define a significant circumstance in your life that may have influenced your ability or need to get coverage, you may qualify through special enrollment and can get health insurance outside of the open enrollment period.\u00a0

Special tip<\/strong>: If you\u2019re unsure if your circumstance would qualify, call your Marketplace or email your HR and say you\u2019d like to be considered for special enrollment due to [state life reason]. Let the representative tell you if you would be eligible. And if you are, they will carry you through with the next steps. Don\u2019t doubt that your circumstance would be ineligible until you actually ask.

Only downfall: the call wait time for Marketplace reps or persistence for a follow-up with HR, but don\u2019t let that discourage you!
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Where do I apply based on my state?<\/summary>\n
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Employment:<\/em>
You will need to apply via your company’s instructions, usually through your company portal.

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Marketplace:
<\/em>If you see your state in the list below<\/strong>, your state has its own Marketplace and website.

If your state isn\u2019t in the list below<\/strong>, your marketplace will be through Healthcare.gov and the needed information is within the method menus underneath.

You can apply online, through phone, through a broker, enrollment partner websites, or with a paper application. The pros and cons of each method are included below the list of states.
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California<\/a><\/p>\n<\/div>\n\n\n\n

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Colorado<\/a><\/p>\n<\/div>\n\n\n\n

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Connecticut<\/a><\/p>\n<\/div>\n<\/div>\n\n\n\n

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District of Columbia<\/a><\/p>\n<\/div>\n\n\n\n

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Idaho<\/a><\/p>\n<\/div>\n\n\n\n

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Kentucky<\/a><\/p>\n<\/div>\n<\/div>\n\n\n\n

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Maine<\/a><\/p>\n<\/div>\n\n\n\n

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Maryland<\/a><\/p>\n<\/div>\n\n\n\n

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Massachusetts<\/a><\/p>\n<\/div>\n<\/div>\n\n\n\n

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Minnesota<\/a><\/p>\n<\/div>\n\n\n\n

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Nevada<\/a><\/p>\n<\/div>\n\n\n\n

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New Jersey<\/a><\/p>\n<\/div>\n<\/div>\n\n\n\n

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New Mexico<\/a><\/p>\n<\/div>\n\n\n\n

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New York<\/a><\/p>\n<\/div>\n\n\n\n

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Pennsylvania<\/a><\/p>\n<\/div>\n<\/div>\n\n\n\n

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Rhode Island<\/a><\/p>\n<\/div>\n\n\n\n

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Vermont<\/a><\/p>\n<\/div>\n\n\n\n

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Virginia<\/a><\/p>\n<\/div>\n<\/div>\n\n\n\n

Washington<\/a><\/p>\n\n\n\n

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Methods of Applying:<\/strong><\/p>\n\n\n\n

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Online<\/summary>\n
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Pro: <\/strong>can go through all of the available plans yourself; work on it at your pace during your availability

Con:<\/strong> will need to have a general understanding of knowing what to look for in a plan

Tip:<\/strong> applying online is recommended since it’s the most efficient and ensures you have the information available right in front of you. U&U offers various resources to help you understand that information and decide what you’re looking for. Use the phone and local broker options as an additional resource for when you have questions about the application.

To apply online, go onto https:\/\/www.healthcare.gov\/get-coverage\/<\/a> or click your respective state above for their marketplace details.<\/p>\n<\/div>\n\n\n\n

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Phone<\/summary>\n
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Pro<\/strong>: can talk to someone to help guide you through.

Con<\/strong>: wait time is very long before getting an agent on the call.

Tip<\/strong>: most times, the phone option is better left if you have specific questions about your application.

You can call Healthcare.gov at 1-800-318-2596 (open 24 hours a day, 7 days a week except holidays. However,<\/strong> if your state is listed above, click it and contact your state’s specific Marketplace.<\/p>\n<\/div>\n\n\n\n

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Local Brokers\/Agents<\/summary>\n
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Pro:<\/strong> connects you with someone local to you that can help discuss what plan is best for you and assist in applying; less wait time than calling your respective marketplace; language accessibility

Con: <\/strong>you will have to work with their schedule; have to take the time to explain your needs for health insurance; personalities might not pair well

Tip:<\/strong> this option is most helpful to gain input on the various plan options you have available to you. It also helps if you’re not a native English speaker and would like someone to explain the plans and help you apply. However, make sure you’re aware of what you need with your health insurance plan.

You can find a partnered Marketplace broker through providing your zip code here: https:\/\/localhelp.healthcare.gov\/<\/a>.<\/p>\n<\/div>\n\n\n\n

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Enrollment Partner Websites<\/summary>\n
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These websites are essentially the same as applying online, however they are through a specific insurance company partnered with the Marketplace. The company dictates whether they show all of the plans in your area or only the ones they offer.

Pro: <\/strong>if you have a specific company that you’d like to apply through that is associated with the Marketplace, this allows you to go directly through their website; tax credits are still eligible

Con:<\/strong> can limit your plan options; adds an extra website rather than directly applying through the Marketplace

Tip: <\/strong>apply directly through the Marketplace even if you know a specific carrier to simplify the process and navigation.

If you’re interested in seeing your state’s enrollment partners, follow this link: https:\/\/www.healthcare.gov\/direct-enrollment\/<\/a>. This link will not help if your state is listed above since your state has its own Marketplace.<\/p>\n<\/div>\n\n\n\n

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Paper <\/summary>\n
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Pro:<\/strong> if you do not have access to technology\/Internet; if you’re not keen on navigating online

Con: <\/strong>mailing takes an extremely long period of time, risking your application deadline

Tip:<\/strong> this should be a last resort if you really cannot find a way to apply online or through phone since mailing is always a risk.

Find instructions here: https:\/\/www.healthcare.gov\/downloads\/marketplace-application-for-family-instructions.pdf <\/a>

Note: <\/strong>if your state is listed above, the application will be different. Click your state to learn more.
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What documents will I need?<\/summary>\n
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While states with their own Marketplace may have their own specific requirements, most Marketplaces will ask you for similar documents to verify your income, citizenship or immigration status, social security number, and lack of minimal essential coverage through an employer. These documents need to be submitted as soon as possible after submitting your application. It will take up to 2 weeks for these documents to be reviewed, which factors into the start of your coverage.

In addition, you may be asked to confirm that you don’t have qualifying health coverage through another government program (Medicaid, CHIP, TRICARE, Veterans Health Care Program, Medicare, and Peace Corps). Being qualified for these programs would prohibit you from being eligible for Marketplace insurance.

To see a list of accepted documents to help you prepare, click here<\/a> for an official list divided by topic by Healthcare.gov. If you see your state in the list below, click it to be redirected to your state’s Marketplace list of accepted documents.

California<\/a>, Colorado<\/a>, Connecticut<\/a>, District of Columbia<\/a>, Idaho<\/a>, Kentucky<\/a>, Maine<\/a>, Maryland<\/a>, Massachusetts<\/a>, Minnesota<\/a>, Nevada<\/a>, New Jersey<\/a>, New Mexico<\/a>, New York<\/a>, Pennsylvania<\/a>, Rhode Island<\/a>, Vermont<\/a>, Virginia<\/a>, Washington<\/a>
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Recommended Reading: <\/strong><\/p>\n\n\n\n

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How to Choose the Best Plan for You!<\/a><\/p>\n\n\n\n

There may be many health insurance plans available to you. But how do you know which plan is the best for you? <\/p>\n\n\n\n

Learn how here<\/a>! <\/p>\n<\/div>\n<\/div>\n\n\n\n

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Stay Updated on the Latest News!<\/h2>\n\n\n\n

Don’t be Unaware:<\/p>\n\n\n\n

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